Cervical Cancer Screening in Low‐ and Middle‐Income Countries

David-West, Gizelka; Maza, Mauricio; Hartmann, Beatrix; Shirazian, Taraneh; Cremer, Miriam; Ditzian, Lauren R.

doi:10.1002/msj.20263

Cited by 32 publications

(17 citation statements)

References 43 publications

(49 reference statements)

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“…Monitoring programs offer opportunities for improvement in cervical cancer control, even before HPV vaccine is routinely adopted in all countries. 49,50 There is still much to be done in Latin America and the Caribbean to effectively control cancer. Early diagnosis and prevention initiatives are the necessary activities.…”

Section: Discussionmentioning

confidence: 99%

Cancer Burden in Latin America and the Caribbean

Curado

Souza

2014

Annals of Global Health

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Establishing knowledge on the real impact of incidence, mortality, and survival in Latin America and the Caribbean is quite a challenge due to the lack of an updated and dynamic information system on mortality and incidence, although some improvement has been made in the information systems of some countries within the most recent decade. Other obstacles for cancer control are the uneven allocation of resources, lack of investments in equipment and infrastructure, and the concentration of health care professionals in large urban centers, which contribute to the reproduction of socioeconomic iniquities in the assistance of populations that suffer from cancer.

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Section: Discussionmentioning

confidence: 99%

Cancer Burden in Latin America and the Caribbean

Curado

Souza

2014

Annals of Global Health

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“…The health and economic implications of this test have been analyzed for health care systems throughout Latin America. [1][2][3][4] Although the Pap test has helped to significantly reduce the burden of disease from cervical cancer in a number of highincome countries, as suggested by strong epidemiologic data, [5][6][7] high incidence rates and related deaths persist in many middle to low-income Latin American nations. 8,9 In some cases, these findings may be explained by the socioeconomic disparities and high levels of marginalization throughout the region.…”

Section: Objetivo Estimar El Costo Anual Del Programa Nacional De Dementioning

confidence: 99%

Cost of the Cervical Cancer Screening Program at the Mexican Social Security Institute

et al. 2014

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Objective. To estimate the annual cost of the National Cervical Cancer Screening Program (CCSP) of the Mexican Institute of Social Security (IMSS). Materials and methods. This cost analysis examined regional coverage rates reported by IMSS. We estimated the number of cytology, colposcopy, biopsy and pathology evaluations, as well as the diagnostic test and treatment costs for cervical intraepithelial neoplasia grade II and III (CIN 2/3) and cervical cancer. Diagnostic test costs were estimated using a micro-costing technique. Sensitivity analyses were performed. Results. The cost to perform 2.7 million cytology tests was nearly 38 million dollars, which represents 26.1% of the total program cost (145.4 million). False negatives account for nearly 43% of the program costs. Conclusion. The low sensitivity of the cytology test generates high rates of false negatives, which results in high institutional costs from the treatment of undetected cervical cancer cases.

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“…[2] A cytology-based cervical cancer prevention program was established in El Salvador in 2001, yet rates of screening remain low. [3][4][5][6][7] Agurto et al (2004) [4] posited that the primary barrier to the prevention of cervical cancer in low-resource settings is not the cost of a screening test, but rather the cost and complexity of providing the infrastructure necessary for a comprehensive program. Murillo et al (2008) [8] showed that even when cytology coverage rates improved, there was no significant decrease in mortality from cervical cancer.…”

Section: Introductionmentioning

confidence: 99%

Adherence to recommended follow-up care after high-grade cytology in El Salvador

Maza¹,

Matesanz

Alfaro³

et al. 2016

IJH

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Objective: To quantify adherence to recommended follow-up care among women in the Paracentral region of El Salvador who were diagnosed by cytology with high-grade squamous intraepithelial lesions (HSIL) of the cervix. Materials and methods: A retrospective chart review was conducted to determine follow-up in the first year after cytological diagnosis of high-grade cervical dysplasia (HSIL). A small sample of these women were also interviewed to determine barriers to care. Results: Patient charts were available for 99 study-eligible patients with HSIL. Only 44% (44/99) of women completed recommended follow-up. Among the 55 women who did not complete follow-up (56% of 99 reviewed), loss to follow-up occurred when women did not schedule a colposcopy appointment (61.8%), did not receive their cytology results (20%), did not return to the clinic to receive their biopsy results, (9.1%), or did not attend their scheduled colposcopy (1.8%). No other factors had a significant effect on adherence to recommended follow-up. An additional 7.3% did not complete their treatment within the one-year time frame designated by the study to represent completion of follow-up. Failure to follow-up among the 13 non-compliant women interviewed was due to lack of money (38%), appropriate referral (28%), and fear (15%). Conclusions: The likelihood of non-adherence increased with longer wait times for follow-up appointments. The data supports the need for systemic interventions to decrease wait time for colposcopy. Changes in both systems and infrastructure have been initiated in El Salvador in order to establish more reliable methods for efficient follow-up care. Further investigation of barriers to care at every point in the process of cervical cancer screening and treatment will highlight which steps require modification.

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Cervical Cancer Screening in Low‐ and Middle‐Income Countries

Cited by 32 publications

References 43 publications

Cancer Burden in Latin America and the Caribbean

Cancer Burden in Latin America and the Caribbean

Cost of the Cervical Cancer Screening Program at the Mexican Social Security Institute

Adherence to recommended follow-up care after high-grade cytology in El Salvador

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